Biomedical subjects
Publications and source records attributed to J A Sandiford.
The Arlington Hospital Needlestick Injury (NSI) Prevention Program was created to protect healthcare workers from NSI and to assess the effectiveness of our interventions. Interventions included revising NSI policy and procedures. The average NSI rate dropped from 109 to 43 per year after the interventions, over a period of 4 years.
The salmonella group of bacteria consists of at least 1700 subtypes and causes widespread gastroenteric disease throughout the world, there being approximately two million cases yearly in the United States alone. An uncommon but interesting complication is the hematogenous lodgment of organisms in other sites of the body with resultant localized abscess formation, often months or years later. We present a review of 15 cases seen in our affiliated hospitals over a nine-year period. Remote salmonellosis most often occurs in patients with underlying systemic disease, such as lupus, malignancy, diabetes, and sickle cell disease, or in association with therapy that suppresses host resistance including steroids and cancer chemotherapy. The most frequent sites of involvement are bone marrow, joints, meninges, pleura, and blood vessels, or in an area of locus minoris resistentiae. The latter include scars, hematomas, fracture sites, prosthetic devices, and neoplasms. Our experience would suggest that these infections, which can remote both in location and time from the original gastrointestinal episode, are perhaps more frequent today than is generally realized. Diagnosis is often delayed because of lack of familiarity with this entity. Treatment consist of either drainage or excision of infected tissue often combined with long-term antibiotics.
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Anal stenosis, an often unrecognized condition causing acute colonic obstruction in the elderly, is described with reference to three cases. Initial management should include: 1) digital dilatation and rectal examination; 2) sigmoidoscopy; 3) insertion of a rectal tube; 4) correction of fluid and electrolyte imbalance. Sufficient experience is not available to predict the results of sphincterotomy or anoplasty, both of which may result in incontinence, and conservative measures may suffice in most cases. Prevention of this condition may be achieved by adequate intake of dietary fiber or regular bulk laxatives in these debilitated patients.
We present a case of advanced ovarian carcinoma associated with high concentrations of serum and urine amylase. Biochemical analysis to elucidate the nature and origin of the hyperamylasemia identified seven amylase isoenzymes, of which five appeared to be distinct from normal salivary and pancreatic amylase. We discuss the nature of amylase isoenzymes produced by malignant tumors.
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